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State ex rel Workers Safety and Compensation Division v. Jackson12/21/1999
98-110.pdf from 98-110
W.R.A.P. 12.09(b) Certification from the District Court of Albany County: The Honorable Jeffrey A. Donnell, Judge
*Retired November 2, 1998.
NOTICE: This opinion is subject to formal revision before publication in Pacific Reporter Second. Readers are requested to notify the Clerk of the Supreme Court, Supreme Court Building, Cheyenne, Wyoming 82002, of any typographical or other formal errors in order that corrections may be made before final publication in the permanent volume.
LEHMAN, Chief Justice.
The question presented is whether, under the Wyoming Worker=s Compensation Act, collateral estoppel may be premised on an uncontested denial of a claim by the Worker=s Compensation Division (Division). Relying on Tenorio v. State, ex rel. Workers= Compensa- tion Div., 931 P.2d 234, 237 (Wyo. 1997), we conclude that an uncontested denial of a claim by the Division will not be given collateral estoppel effect in subsequent proceedings for outstanding claims. We affirm the hearing examiner=s order awarding benefits.
ISSUES
We adopt the injured worker=s statement of the issue:
Did the Hearing Examiner commit error in finding that Mrs. Jackson=s failure to timely object to a final determination addressed to her physician and denying payment of a $45.00 claim did not preclude further claims?
FACTS
Appellee Lila Jackson (Jackson) suffered a work-related injury in December of 1992. While working as a bus driver for the Laramie Senior Center, she slipped and fell climbing the bus steps, injuring her left ankle. She timely filed an injury report. After review, the Division concluded that Jackson=s injury was covered by the Worker=s Compensation Act.
The ankle did not respond to therapy, and surgery was required. In March of 1993, Jackson underwent the first of three surgeries on her ankle. This surgery did not solve her problems, however, and pain and swelling in the ankle continued. In May of 1994, Jackson underwent another surgery. This time, the bones in her ankle were fused, and she was fitted with an ankle support brace. The brace attaches to the heel of Jackson=s shoe, and its two metal supports run up the sides of her leg to another attachment just below the knee.
The brace significantly alters Jackson=s gait, causing a limp and creating excessive strain on her right hip and right knee. Prior to wearing the brace, Jackson did not have any hip or knee problems. Two months after being fitted with the brace, however, Jackson began experiencing pain in her right hip and right knee. First diagnosed with trochanteric bursitis (bursitis of the hip), Jackson has since developed degenerative arthritis in both joints. In just three years, Jackson=s condition has deteriorated to the point that her orthopedic surgeon believes both joints need to be replaced.
Sometime in the fall of 1996, Jackson=s orthopedic surgeon filed a claim with the Division, seeking payment of a $45 bill for treatment of Jackson=s hip and knee. On October 2, 1996, the Division issued a final determination, addressed to the orthopedic surgeon, denying the $45 claim. This final determination provided:
FINAL DETERMINATION
DENIAL OF AMOUNT IN QUESTION $45.00
The Division has reviewed the response and denied payment on the referenced bill in the amount shown above for the following reason(s).
The hips and knees have not been established as part of the original workers= compensation left ankle injury. This denial is based upon the Division=s authority to review all medical records pursuant to Wyoming Sta
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